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FACT SHEET on Mandatory Overtime
Mandatory Overtime for Health Care Workers is Endemic
- Mandatory overtime began as a rarely used response to unforeseen emergencies, primarily in acute care hospitals. Since the mid 1990s, hospitals have increasingly used mandatory overtime as a cost cutting measure. Mandatory overtime is now part of a deliberate strategy in many hospitals to operate with less direct care staff.
- Nurses and other health care professionals across the state report that they are being forced to work overtime when they are exhausted after 12 hour shifts. According to a national survey by SEIU, nurse’s now work an average of 8 ½ weeks of overtime a year.[1]
- An SEIU survey of Wisconsin RNs who provide direct care in hospitals found that 42% had been mandated.[2]
- In order to further reduce costs, hospitals are increasingly extending mandatory overtime to non-professional hospital workers.
Mandatory Overtime is Driving Nurses Out of the Profession
- Nurses throughout Wisconsin and across the nation report that mandatory overtime leads to nearly overwhelming fatigue, and reaps havoc on family lives. They believe that it is one of the primary reasons so many nurses are either finding non-hospital jobs, or leaving nursing altogether.
- 84% of Wisconsin RNs believe that nurses are leaving the profession because of poor staffing and mandatory overtime.[3]
- According to a major investigative report by the Chicago Tribune, “hospitals across the country regularly blame the shortage of nurses for staffing deficiencies, but in reality, there is more often a shortage of nurses willing to work in hospitals. Deteriorating, oppressive workplace conditions–from mandatory overtime to stagnant pay–have made hospital jobs less appealing. . . . Mandatory overtime and 16-hour shifts have driven many nurses away.” A noted nursing expert, Suzanne Gordon, concludes: “Polls and studies show why nurses are leaving their chosen profession: They are fed up with mounting workloads, mandatory overtime, and pay levels.[4]
- Nurses are not only leaving hospitals, they are increasingly leaving nursing altogether. Of the 2.2 million RNs nationally, a record 494,000 were not using their licenses.[5]
- The situation will only grow worse unless conditions are improved. According to a national survey of nurses, one in five is seriously considering leaving the profession due to poor working conditions.[6]
- The situation is even worse among young nurses. A recent University of Pennsylvania School of Nursing Study found that 1 in 3 nurses under 30 years of age plan to leave the profession within the next year.[7] Yet, according to the U.S. Department of Labor, an additional 450,000 nurses will be needed by the year 2008.
- More money for nurse education will not solve the problem. As nursing expert Suzanne Gordon explains: “Veteran nurses and even recent nursing school graduates are discouraging others from entering the field and even advising nursing students to get out of bedside care as soon as they can. Without substantive changes in working conditions, luring more people into the profession will aggravate, not alleviate the situation and encourage the “management by churn” that has reduced customer service quality in fast food, retail sales, and telemarketing, where the consequences are far less serious for customers than in health care.”[8]
- According to Julie Sochalski of the University of Pennsylvania School of Nursing: “Solutions that are focused on strategies to recruit more nurses will not ameliorate the problem in the long run if equal attention is not paid to strategies to retain the current and future workforce. . . “[9]
- There is still time to solve the problem in Wisconsin. While there is a national nursing shortage, Wisconsin has yet to feel the brunt of it. Recent statistics show Wisconsin has 8.93 nurses per thousand population, which is well above the national average of 7.82 nurses per thousand.[10]
Health Care Mandatory Overtime is Bad Medicine
- Nurses, who are mandated more than any other occupational category, are the most important factor in quality acute care. They provide the bulk of patient care and they provide early warning and rapid intervention for critically ill patients. Fatigued nurses are much more likely to make errors, or to miss subtle changes in the condition of patients.
- The highly-regarded Institute of Medicine reports that as many as 98,000 patients die from medical errors in hospitals each year. Nurses are involved in more medical errors because they have by far the most contact with patients. According to a national study by the Chicago Tribune, nurse errors lead to at least 1,720 deaths and 9,584 injuries each year. Because 75% of hospitals do not report their medical errors to federal authorities, these numbers are substantially understated.[11]
- Mandatory overtime also diminishes the quality of care, even when injuries are avoided. As Lucian Leape of the Harvard School of Public Health concludes: “It really ought to be illegal for nurses to work double shifts. You don’t allow flight attendants to work more than eight hours. Why would anyone think that nurses are less important?”[12]
There is a major bi-partisan effort underway in Wisconsin to prohibit mandatory overtime for health care workers, except in cases of unforeseen emergency. SEIUWisconsinStateCouncil urges support for AB 451 sponsored Rep. DuWayne Johnsrud (R-Eastman), and the companion bill SB 177 by Sen. Judy Robson (D-Beloit).
For more information contact Matthew Brusky, (414) 223-0095, m-brusky@seiu-wisconsin.org
(Last revised August29, 2003)
[1] SEIU Nurse Alliance, The Shortage of Care: How to Solve the Nursing Shortage by Treating the Disease, Not the Symptoms (May 2001): 3.
[2] A soon to be released SEIU survey of 1486 RNs in Wisconsin.
[3] SEIU survey of 1486 RNs in Wisconsin.
[4]ChicagoTribune (September 10, 2000); Suzanne Gordon, “Nursing is What Needs the Cure,” Los Angeles Times (August 13, 2001).
[5]New York Times, (April 8, 2001).
[6]Federation of Nurses and Health Professionals, National Survey by Peter Hart Research, April 19, 2001.
[7]Linda H. Aiken, et al, “Nurses’ Reports on Hospital Care in Five Countries,” Health Affairs 20 (May/June 2001): 43-53.
[8]Suzanne Gordon, “Nursing is What Needs the Cure,” Los Angeles Times (August 13, 2001).
[9]Hearings, U.S. Senate Health, Education, Labor and Pensions Committee, May 18, 2001.
[10]Bonnie Strauss, Testimony before Joint Audit Committee, June 28, 2001.
[11]ChicagoTribune, September 10, 2000.
[12]New York Times, April 8, 2001.
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